Waitlisted To Death At The VA

The controversy really began after CNN reported in April that at least 40 US veterans died while waiting for appointments at the Phoenix VA hospital. According to internal emails and CNN’s sources, VA managers in Phoenix created a secret wait list in an attempt to hide that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor. Even worse, top-level management supposedly knew of and defended the practice.

Besides the secret list, the Phoenix VA hospital already provided a different, official wait list to DC that allowed VA higher-ups to verify that patients are being treated in a timely manner (within 14 to 30 days). But Phoenix’s secret wait list supposedly avoided federal oversight with an elaborate scheme in which officials shredded evidence that some patients were taking months to be seen. What’s worse, if someone died while waiting for an appointment due to the secret wait list, Phoenix officials would allegedly discard the name as if the fatal error never happened.

He adds that “there’s also been issues with scheduling practices in at least three other locations.” Shinseki’s testimony didn’t impress veterans groups:

After the hearing, the Iraq and Afghanistan Veterans of America, which has a broad membership base among younger veterans, released a statement that read, “Secretary Shinseki did not restore confidence that VA senior leadership is responding with action and not just concern. Our members are outraged. And we need to see a bold plan to address these allegations.”

None of the veterans’ groups, including the conservative American Legion, which has called for Shinseki to resign, endorsed the idea of replacing centralized, VA-provided care with a private option. Republican senators have repeatedly floated the idea of privatizing the VA’s healthcare system. Veterans’ organizations on the panel endorsed a limited private care option but warned that it shouldn’t take away from the VA’s budget or its mandate to be the primary healthcare provider for veterans. Carl Blake of the Paralyzed Veterans of America argued that veterans with certain chronic injuries and demanding physical condition who now receive care might not be able to find private specialists outside the VA to treat them. The problem, he stressed, was getting the veterans into the VA’s healthcare system.

[Shinseki] has already said he won’t resign. What’s critical is how Congress and veterans react to what he says, and what a VA-wide inspector general’s probe into the problem turns up. Shinseki will survive if he convinces them he was ignorant of such wrongdoing—he has denounced it as “absolutely unacceptable”—and shouldn’t have been expected to detect it on his own.

But anyone who has paid attention to VA data is aware that there have been persistent efforts inside the agency to make vets’ wait times seem shorter than they actually are. One 14-day limit for getting an appointment was ripe for abuse, and critics say such abuse should have been anticipated and eliminated. Shinseki’s defense becomes weaker with every corroborated story of his subordinates gaming the system. If there’s evidence that the problems are systemic, Shinseki’s days are numbered.

There is also a risk that the recent focus on breakdowns in the VA hospital system will cause President Obama and Congress to overlook the other huge failing at the VA—a sluggish, error-prone disability system that will never work until it moves completely from paper processes to a state-of-the-art electronic system. VA disability paperwork is so voluminous that the General Services Administration became concerned a few years ago that a building in Virginia would collapse from the sheer weight of its stored VA disability paperwork. Predictably, waiting times for review have slowed to historically sluggish levels; a former soldier, whether injured in Afghanistan or Vietnam, should not have to wait years for a decision on his or her claim.

Jordain Carney and Stacey Kaper explain how the VA has gotten so overloaded in recent years:

The VA is dealing with a sudden influx of Afghanistan and Iraq veterans as the U.S. draws down its troop levels. Nearly 970,000 Iraq and Afghanistan war veterans deployed overseas since 9/11 have filed a disability claim, according to a Freedom of Information Act request released to Veterans for Common Sense this month by the Veterans Benefits Administration.

And due to medical advances, many service members who would have died from their injuries in past wars are now being saved, but they are returning home with more numerous and more complicated injuries. Vietnam veterans typically claimed three or four injuries. Now a single veteran from Iraq or Afghanistan routinely submits a claim with the number of injuries in the double digits. Meanwhile, the Obama administration has also changed the rules to give more benefits to veterans.